What is a silent heart attack?

A silent heart attack is one in which a person does not feel typical symptoms of a heart attack, such as:

Chest pain or pressure, or a strange feeling in the chest.

Sweating.

Shortness of breath.

Nausea or vomiting.

Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or one or both shoulders or arms.

Lightheadedness or sudden weakness.

A fast or irregular heartbeat.

This type of heart attack is usually not detected unless there are symptoms of another condition, such as heart failure, at the same time. It may not be discovered until later, during a routine physical exam.

A silent heart attack may occur when the nerves in the heart have been damaged by high blood sugar due to diabetes. Because the heart attack does not cause symptoms, it is ignored or not noticed and often causes more damage to the heart. In a person with diabetes, the only signs of a heart attack may be a rising blood sugar level and weakness that does not go away after eating sugar.

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So-called silent heart attacks are episodes in which part of the heart is damaged when something blocks blood flow through a coronary artery, but the symptoms that accompany the blockage are so subtle that they go unnoticed or are ignored. Silent heart attacks are usually discovered when a person undergoes an electrocardiogram or echocardiogram for a different reason and the test shows abnormalities suggestive of damage to the heart.

Just because a heart attack didn't cause chest pain or other severe symptoms doesn't mean it shouldn't be taken seriously. Individuals who have had silent heart attacks are at high risk of having additional episodes, one of which could be fatal or cause enough damage to lead to heart failure. If you have had a silent heart attack, you should be every bit as attentive to controlling your risk factors for atherosclerosis as someone who has had the traditional "noisy" kind.

Sometimes people will find out they had a "silent" heart attack when they have an electrocardiogram (ECG) done for something other than their heart. For instance, an ECG is often done before an elective surgery prior to receiving anesthesia. When questioning a patient about a silent heart attack, often the heart attack wasn't really silent. Some patients may recall a time when they felt really ill with what they thought was severe heart burn. Severe heart burn unrelieved by antacids can sometimes be a symptom of heart disease. Diabetics are a population that often have "silent" heart attacks. For this reason, diabetics are often treated as if they already have heart disease and will be encouraged to take a baby aspirin a day and treated with cholesterol lowering drugs.

A silent heart attack occurs in the absence of chest pain. A silent heart attack is caused by the same factors that cause angina. Silent heart attacks affect people who do not have any symptoms of heart attack and have no evidence of coronary heart disease, people who have had a heart attack in the past, and people with angina who also have episodes of silent heart attack. The cause of the silent heart attack is unknown.

Articles

Caused when our heart cells die from a lack of oxygen, a heart attack requires immediate medical attention to prevent severe heart damage and death.
The leading cause of death among Americans, a heart attack, also called a myocardial infarction (MI), often results from coronary artery disease, the most common form of heart disease to affect adults.
Coronary artery disease, which can develop over years, is caused when a fatty substance called plaque builds up in the arteries and restricts the supply of blood and oxygen to our hearts. The plaque can eventually cause a blood clot to form on its surface, which can completely block the flow of oxygenated blood to our hearts. If blood flow isn’t restored quickly, the heart muscle begins to die.
See your doctor immediately if you feel pressure or a squeezing sensation in your chest, neck, jaw, shoulders, back or arms, especially if it’s accompanied by sweating, nausea, vomiting, or shortness of breath.